Individual
DR. MARK L DOUGLAS
Active
Individual
DR. MARK L DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1390
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001722523
BLUE CROSS BLUE SHIELD
WV
01
—
0839644
MEDICARE PIN
WV
01
—
4333567
AETNA
WV
01
—
550773123
TAX ID
WV
Enumeration date
03/01/2007
Last updated
12/31/2012
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up